Give Blood Examples of Respiratory Acidosis and Metabolic Acidosis

Acidosis is caused by an overproduction of acid that builds up in the blood or an excessive loss of bicarbonate from the blood (metabolic acidosis) or by a buildup of carbon dioxide in the blood that results from poor lung function or depressed breathing (respiratory acidosis).

• Blood acidity increases when people ingest substances that contain or produce acid or when the lungs do not expel enough carbon dioxide.

• People with metabolic acidosis often have nausea, vomiting, and fatigue and may breathe faster and deeper than normal.

• People with respiratory acidosis often have headache and confusion, and breathing may appear shallow, slow, or both.

• Tests on blood samples typically show pH below the normal range.

• Doctors treat the cause of the acidosis.

The kidneys also try to compensate by excreting more acid in the urine. However, both mechanisms can be overwhelmed if the body continues to produce too much acid, leading to severe acidosis and eventually heart problems and coma.

The acidity or alkalinity of any solution, including blood, is indicated on the pH scale.

Acidity and alkalinity are expressed on the pH scale, which ranges from 0 (strongly acidic) to 14 (strongly basic or alkaline). A pH of 7.0, in the middle of this scale, is neutral.

Blood is normally slightly basic, with a normal pH range of 7.35 to 7.45. Usually the body maintains the pH of blood close to 7.40.

Acidosis is categorized depending on its primary cause as

• Metabolic

• Respiratory

Metabolic acidosis develops when the amount of acid in the body is increased through ingestion of a substance that is, or can be broken down (metabolized) to, an acid—such as wood alcohol (methanol), antifreeze (ethylene glycol), or large doses of aspirin (acetylsalicylic acid). Many other drugs and poisons can cause acidosis.

Metabolic acidosis also develops when the body loses too much base. For example, bicarbonate can be lost through the digestive tract due to diarrhea or an ileostomy.

Respiratory acidosis develops when the lungs do not expel carbon dioxide adequately (inadequate ventilation), a problem that can occur in disorders that severely affect the lungs (such as chronic obstructive pulmonary disease Chronic Obstructive Pulmonary Disease (COPD) Chronic obstructive pulmonary disease is persistent narrowing (blocking, or obstruction) of the airways occurring with emphysema, chronic obstructive bronchitis, or both disorders. Cigarette... read more , severe pneumonia Overview of Pneumonia Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final... read more , heart failure Heart Failure (HF) Heart failure is a disorder in which the heart is unable to keep up with the demands of the body, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and/or... read more , and asthma Asthma Asthma is a condition in which the airways narrow—usually reversibly—in response to certain stimuli. Coughing, wheezing, and shortness of breath that occur in response to specific triggers are... read more ).

In mild metabolic acidosis, people may have no symptoms but usually experience

• Fatigue

• Nausea

• Vomiting

Breathing becomes deeper and slightly faster (as the body tries to correct the acidosis by expelling more carbon dioxide). As the acidosis worsens, people begin to feel extremely weak and drowsy and may feel confused and increasingly nauseated. Eventually, in severe cases, heart problems may develop and blood pressure can fall, leading to shock, coma, and death.

In respiratory acidosis, the earliest symptoms are

• Drowsiness

• Headache

Drowsiness may progress to stupor and coma as the oxygen in the blood becomes inadequate. Stupor and coma can develop within moments if breathing stops or is severely impaired, or over hours if breathing is less dramatically impaired.

• Blood tests

The diagnosis of acidosis generally requires the measurement of blood pH and carbon dioxide in a sample of arterial blood, usually taken from the radial artery in the wrist. Arterial blood is used because venous blood is generally not as reliable when measuring the body's pH status.

To learn more about the cause of the acidosis, doctors also measure the levels of bicarbonate in the blood. Additional blood tests are then done to help determine the specific cause.

• Treatment of the cause

• Sometimes fluids with bicarbonate given by vein

Almost always, treatment of acidosis is directed at reversing the cause. Doctors rarely simply give alkaline drugs, such as bicarbonate, to reverse the acidosis.

In metabolic acidosis, treatment depends primarily on the cause. For instance, treatment may be needed to control diabetes with insulin or to remove the toxic substance from the blood in cases of poisoning.

Severe acidosis may also be treated directly when it does not respond to efforts to treat the cause. In such cases, bicarbonate may be given intravenously. However, bicarbonate provides only temporary relief and may cause harm—for instance, by overloading the body with sodium and water.

Generic Name	Select Brand Names
albuterol	PROVENTIL-HFA, VENTOLIN-HFA
aspirin	No US brand name

Give Blood Examples of Respiratory Acidosis and Metabolic Acidosis

Source: https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/acid-base-balance/acidosis

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